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Category: Surgery | Monthly Briefing

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April 2011 Briefing - Surgery

Last Updated: May 02, 2011.

 

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Here are what the editors at HealthDay consider to be the most important developments in Surgery for April 2011. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Weight Linked to Post-Hysterectomy Complications

FRIDAY, April 29 (HealthDay News) -- Obesity is associated with increased risk of bleeding and infection after abdominal hysterectomy (AH), while having a body mass index (BMI) of less than 20 kg/m² is linked with bleeding and infection after both AH and laparoscopic hysterectomy (LH), according to a study published online April 5 in Human Reproduction.

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Percutaneously Placed Pedicle Screws Risk Joint Violation

FRIDAY, April 29 (HealthDay News) -- Percutaneously placed pedicle screws in minimally invasive lumbar spinal fusion have higher incidence of cranial facet joint violations than traditionally instrumented screws, according to a study published in the April issue of The Spine Journal.

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Helical Cutting May Improve Tendon Length and Strength

FRIDAY, April 29 (HealthDay News) -- Helical cutting of the Achilles tendon may allow a greater increase in tendon length than z-plasty, along with reliable tendon continuity and improved resistance to tensile load, according to an animal study published in the April 20 issue of The Journal of Bone & Joint Surgery.

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Increasing Cancer Burden Projected for Ethnic Minorities

THURSDAY, April 28 (HealthDay News) -- Consideration of genetic, ethnic, biologic, and sociological factors is necessary to appropriately diagnose and treat cancer in all U.S. subpopulations, according to the President's Cancer Panel 2009 to 2010 report published April 28.

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Flu Vaccination Safe for Post-Transplant Patients

THURSDAY, April 28 (HealthDay News) -- Influenza vaccination in the first year after renal transplantation is not associated with transplant rejection or loss, according to a study published online April 21 in the Clinical Journal of the American Society of Nephrology.

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Acute Neurological Toxicity Tied to Overall Survival

THURSDAY, April 28 (HealthDay News) -- Acute neurological toxicities (NTs) are significantly associated with late NT and overall survival in patients with high-grade gliomas treated with surgery and chemoradiation, according to a study published online April 12 in the British Journal of Cancer.

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Low-Dose Aspirin Affects Post-Surgery Blood Drainage

WEDNESDAY, April 27 (HealthDay News) -- Patients taking low-dose aspirin have significantly increased blood drainage and are at increased risk of complications after spinal surgery, even if they stop taking aspirin seven days before surgery, according to a study published in the April issue of The Spine Journal.

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Preoperative MRI Doesn't Affect Scoliosis Surgery Outcomes

WEDNESDAY, April 27 (HealthDay News) -- Preoperative magnetic resonance imaging (MRI) for adolescent idiopathic scoliosis may not affect the surgical outcome even if a neural abnormality is detected, according to a study published in the April 15 issue of Spine.

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Specialist Transfer to Patients With MI Improves Outcome

WEDNESDAY, April 27 (HealthDay News) -- Transfer of qualified interventionalists to hospitals without interventionalists qualified for primary percutaneous coronary intervention (PPCI) may be more effective at improving care of patients with acute ST-segment elevation myocardial infarction (STEMI) than transferring patients to hospitals with qualified interventionalists, particularly where patient transfers could be delayed by congestion, according to a study published online April 26 in Circulation: Cardiovascular Quality and Outcomes.

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Oophorectomy May Not Adversely Affect Health

WEDNESDAY, April 27 (HealthDay News) -- Elective bilateral salpingo-oophorectomy (BSO) with hysterectomy is associated with a lower risk of ovarian cancer than ovarian conservation and hysterectomy, and BSO does not appear to have adverse effects on cardiovascular health, hip fracture, cancer, or total mortality compared with ovarian conservation and hysterectomy, according to research published in the April 25 issue of the Archives of Internal Medicine.

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More MI Treatments Tied to Decreased Mortality in Sweden

TUESDAY, April 26 (HealthDay News) -- For patients with ST-elevation myocardial infarction (STEMI) in Sweden, an increase in evidence-based treatments is associated with a decrease in 30-day and one-year mortality, according to a study published in the April 27 issue of the Journal of the American Medical Association.

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Black Cancer Patients More Willing to Pay to Extend Life

TUESDAY, April 26 (HealthDay News) -- Black cancer patients are more willing to expend their personal financial resources in order to extend life compared to white cancer patients, according to a study published online April 26 in Cancer.

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Preoperative Definition of Basal Cell Cancer Margins Feasible

TUESDAY, April 26 (HealthDay News) -- Use of topical methyl aminolevulinate (MAL) as a photosensitizer in conjunction with Wood lamp examination is a feasible method for identifying tumor margins in patients with basal cell carcinoma (BCC) prior to Mohs micrographic surgery (MMS), according to a study published in the May issue of the Journal of the American Academy of Dermatology.

Abstract
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Smoking Cessation May Prevent Cancer in Liver Recipients

MONDAY, April 25 (HealthDay News) -- Liver transplant recipients who quit smoking after transplantation have a lower incidence of smoking-related malignancies (SRMs) compared with patients who continue smoking, according to a study published in the April issue of Liver Transplantation.

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Straight Cylindrical Cages Increase Implant Failure Rate

MONDAY, April 25 (HealthDay News) -- Failure to account for the trapezoid shape of the L5 vertebral body may lead to complications following implant fitting during anterior reconstruction, according to a study published in the April issue of The Spine Journal.

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New Weight-Based Guide for Moving Surgical Patients

FRIDAY, April 22 (HealthDay News) -- The decision to move patients to and from a surgical position manually or using assisted technology should be based on their weight and the surgical position, according to a study published in the April issue of the AORN Journal.

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Ectopic Pregnancy Rates Increased in Recent Period

FRIDAY, April 22 (HealthDay News) -- Ectopic pregnancy rates in the United States increased over a recent 15-year period, according to a population-based study published in the May issue of the American Journal of Preventive Medicine.

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Treatment-Resistant Epilepsy Common in Idiopathic Autism

THURSDAY, April 21 (HealthDay News) -- Treatment-resistant epilepsy (TRE) is relatively common in patients with autism, but surgical resection and vagus nerve stimulator (VNS) implantation offer limited benefit, according to a study published online April 19 in Epilepsia.

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High BNP Post-CABG Predicts Worse Physical Function

THURSDAY, April 21 (HealthDay News) -- Higher peak postoperative levels of B-type natriuretic peptide (BNP), secreted by the heart in response to stress, are independently associated with worse physical function up to two years after coronary artery bypass graft (CABG) surgery, according to a study published in the April issue of Anesthesiology.

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Multilevel Surgery Improves Outcomes in Cerebral Palsy

THURSDAY, April 21 (HealthDay News) -- Functional and dynamic positional outcomes improve in children with hemiplegic cerebral palsy who undergo single-event multilevel surgery, according to a study published in the April 6 issue of The Journal of Bone & Joint Surgery.

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New Hemoglobin Sensor May Help in Transfusion Decisions

WEDNESDAY, April 20 (HealthDay News) -- Use of a continuous spectrophotometric hemoglobin (SpHb) sensor may be a useful new approach for noninvasive blood hemoglobin monitoring during surgery, according to a study published in the April issue of Anesthesia & Analgesia.

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Virtual Nasal Surgery Predicts Post-Surgical Outcomes

WEDNESDAY, April 20 (HealthDay News) -- Virtual nasal surgery appears predictive of post-surgical outcomes and may help surgeons tailor their procedure using computer simulation techniques, according to research published online April 18 in the Archives of Facial Plastic Surgery.

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Uremic Patients Risk Spinal Surgery Complications

WEDNESDAY, April 20 (HealthDay News) -- Uremic patients undergoing posterior instrumented lumbar spinal surgery have similar solid fusion rates, but are at increased risk of complications compared to controls, according to a study published in the April 15 issue of Spine.

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More Than Five Million Youth Treated for Football Injuries

WEDNESDAY, April 20 (HealthDay News) -- An estimated 5.25 million children and adolescents in the age group 6 to 17 years were treated for football-related injury in U.S. emergency departments from 1990 to 2007, according to a study published in the March issue of Clinical Pediatrics.

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Low-Cost Thromboprophylaxis by Electronic Alerts Effective

WEDNESDAY, April 20 (HealthDay News) -- Electronic alert (e-alert) systems are cost-effective tools for reducing venous thromboembolism (VTE) in hospitalized patients, according to a study published online April 11 in the Journal of Thrombosis and Haemostasis.

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Perioperative MI Common and Usually Asymptomatic

WEDNESDAY, April 20 (HealthDay News) -- Perioperative myocardial infarction (MI) after noncardiac surgery is the most common major vascular complication, with most patients not experiencing ischemic symptoms, according to a study published in the April 19 issue of the Annals of Internal Medicine.

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People With Anosmia Attach Less Importance to Olfaction

WEDNESDAY, April 20 (HealthDay News) -- The importance of smell in the daily life of people with olfactory disorders appears to be less than those with a normal sense of smell, suggesting healthy adaptation to reduced olfactory function, according to research published in the April issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Off-Label Use of Recombinant Factor VIIa High

WEDNESDAY, April 20 (HealthDay News) -- Off-label use of recombinant factor VIIa (rFVIIa) in the hospital setting greatly exceeds use for approved indications; off-label use does not appear to reduce mortality and may increase the risk for thromboembolism, according to research published in the April 19 issue of the Annals of Internal Medicine.

Abstract - Logan
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Abstract - Yank
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Decreased Length of Stay in Hospital for Hip Arthroplasty

TUESDAY, April 19 (HealthDay News) -- Between 1991 and 2008, the length of stay (LOS) in the hospital for Medicare patients undergoing primary or revision hip arthroplasty decreased, while discharge to skilled care and readmission rates increased, according to a study published in the April 20 issue of the Journal of the American Medical Association.

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Airway Exam Rare in Infants With Life-Threatening Events

TUESDAY, April 19 (HealthDay News) -- Well-appearing infants hospitalized with apparent life-threatening events (ALTEs) rarely undergo airway evaluation or require subsequent otolaryngologic surgical intervention, according to research published in the April issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Alcohol Intake Affects Surgeon Performance the Next Day

TUESDAY, April 19 (HealthDay News) -- Excessive consumption of alcohol the evening before a surgery may negatively affect the surgeon's laparoscopic surgical performance the following day, according to a study published in the April issue of the Archives of Surgery.

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Do-Not-Resuscitate Order Linked to Increased Surgical Mortality

MONDAY, April 18 (HealthDay News) -- Surgical patients with do-not-resuscitate (DNR) orders have more complications and a higher mortality rate than non-DNR patients, according to a study published online April 18 in the Archives of Surgery.

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Closing Wedge Osteotomies Stiffer Than Opening Wedge

MONDAY, April 18 (HealthDay News) -- Closing wedge osteotomies (CWOs) are more mechanically stiff than opening wedge osteotomies (OWOs) in flexion-extension (FE), according to a study published in the April 15 issue of Spine.

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Effective Method to Prevent Diabetic Foot Ulcers Lacking

MONDAY, April 18 (HealthDay News) -- Most of the interventions used to prevent diabetic foot ulcers in insensate feet do not show any evidence of benefit, according to a review published in the April issue of Diabetes Care.

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Guidelines Issued for Pituitary Incidentaloma Treatment

MONDAY, April 18 (HealthDay News) -- Treatment options for patients with pituitary incidentaloma should be decided after a complete history, physical examination, and laboratory screening, and, in certain cases, visual examination, according to the new Clinical Practice Guideline (CPG) published in the April issue of the Journal of Clinical Endocrinology & Metabolism.

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Colorectal Cancer Mortality Varies Between Hospitals

FRIDAY, April 15 (HealthDay News) -- Thirty-day postoperative mortality following major colorectal cancer surgery varies significantly between hospitals, according to a study published online April 12 in Gut.

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Statins May Lower Post-Surgery Renal Complications

FRIDAY, April 15 (HealthDay News) -- Patients who use statins before major elective surgery may have a decreased likelihood of post-surgery renal complications and reduced postoperative mortality, according to a study published online April 14 in the Journal of the American Society of Nephrology.

Abstract
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Editorial (subscription or payment may be necessary)

Penile Implant Use Low After Prostate Cancer Treatment

FRIDAY, April 15 (HealthDay News) -- The utilization of penile implants is low in men who have had prostate cancer treatments, including radical prostatectomy (RP) or radiotherapy (RT), but is more likely in those who have had RP than RT, according to a study published online March 22 in The Journal of Sexual Medicine.

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Donor-Specific Antibodies May Increase Arteriosclerosis

FRIDAY, April 15 (HealthDay News) -- Arteriosclerosis progression occurs in renal allograft recipients with and without donor-specific antibodies (DSA), and it is significantly increased in patients with DSA, according to a study published online April 14 in the Journal of the American Society of Nephrology.

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Self-Rated Health Predicts Outcomes of Joint Replacement

THURSDAY, April 14 (HealthDay News) -- Mental well-being and self-rated health (SRH) predict outcomes of total joint replacements, more than patients' prior physical health, according to a study published online March 18 in Arthritis Care & Research.

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FDA: Penumbra Coil 400 System Recalled

THURSDAY, April 14 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care providers of a class 1 recall of Penumbra Inc.'s Penumbra Coil 400 system, as a defect may cause premature detachment of the coil, which can lead to serious injury, including blood clots and stroke, due to the coil unintentionally migrating.

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Spinal Fusion Well Tolerated in Idiopathic Scoliosis

THURSDAY, April 14 (HealthDay News) -- Despite accelerated L5-S1 disc degeneration, patients with adolescent idiopathic scoliosis (AIS) maintain good function and balance more than 10 years after spinal fusion, according to a study published online Feb. 1 in Spine.

Abstract
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Anesthesia Complications Twice As Likely in Obese

THURSDAY, April 14 (HealthDay News) -- Airway management is a basic anesthetic responsibility and skill, and strategies need to be implemented to appropriately manage difficult airways, according to the Fourth National Audit Project (NAP4) of the Royal College of Anaesthetists and the Difficult Airway Society, published online March 29 in the British Journal of Anaesthesia.

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Ex Vivo Lung Perfusion May Increase Use of Available Lungs

THURSDAY, April 14 (HealthDay News) -- Use of normothermic ex vivo lung perfusion (EVLP), which allows for assessment of a donor lung's function, could render suitable for transplantation lungs that otherwise would not have been considered, according to research published in the April 14 issue of the New England Journal of Medicine.

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MRSA Prevention Programs Have Conflicting Results

WEDNESDAY, April 13 (HealthDay News) -- A program involving intensive efforts to prevent the incidence and spread of methicillin-resistant Staphylococcus aureus (MRSA) infections in health care facilities does not appear to be effective, though another program involving the same types of efforts does seem to be, according to two studies with conflicting findings published in the April 14 issue of the New England Journal of Medicine.

Full Text - Huskins (subscription or payment may be required)
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Bone Marrow Recipients Develop PML Symptoms Earlier

TUESDAY, April 12 (HealthDay News) -- Bone marrow recipients have a shorter average time to development of the first symptoms of progressive multifocal leukoencephalopathy (PML), but they may survive longer than solid organ recipients post symptom onset, according to a study published online March 7 in the Annals of Neurology.

Abstract
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First-Procedure Delays Linked to Tardy Surgeons

TUESDAY, April 12 (HealthDay News) -- Operating room (OR) first-procedure delays can be significantly reduced if the surgeons arrive on time for their procedures, according to a report published in the April issue of the AORN Journal.

Abstract
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SLN Biopsy Predicts Lymph Node Status in Endometrial CA

TUESDAY, April 12 (HealthDay News) -- Sentinel lymph node (SLN) biopsy appears promising as a less invasive alternative to complete lymphadenectomy for diagnosing lymph node status in patients with early-stage endometrial cancer, according to research published online April 12 in The Lancet Oncology.

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Bipolar Sealer Not Preferable to Electrocautery in Arthroplasty

FRIDAY, April 8 (HealthDay News) -- Use of a bipolar sealer to achieve hemostasis during uncomplicated primary total hip arthroplasty does not appear to have any advantages over standard electrocautery, according to research published in the March 16 issue of The Journal of Bone & Joint Surgery.

Abstract
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FDA OKs Rapid Test to Spot C. difficile Infection

FRIDAY, April 8 (HealthDay News) -- A test designed to rapidly detect the genetic fingerprint of Clostridium difficile bacterial infection has been approved by the U.S. Food and Drug Administration.

Centers for Disease Control and Prevention

'Global Trigger Tool' Identifies 10 Times More Errors

THURSDAY, April 7 (HealthDay News) -- Use of the new Global Trigger Tool, developed by the Institute for Healthcare Improvement, detects at least 10 times more adverse events than other methods currently in use, according to a study published in the April issue of Health Affairs.

Abstract
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Community-Associated MRSA Infections Are Seasonal

MONDAY, April 4 (HealthDay News) -- During the summer and autumn months, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections peak in all ages; whereas hospital-associated MRSA (HA-MRSA) peaks are seen in pediatric patients only, according to a study published March 23 in PLoS ONE.

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Breast Cancer Survival Factors for Underserved Identified

MONDAY, April 4 (HealthDay News) -- Advanced stages at presentation, and limited diagnostic and treatment capabilities, contribute to lower breast cancer survival in low-income and middle-income countries (LMC), according to the executive summary of the Breast Health Global Initiative Consensus 2010, published in the April issue of The Lancet Oncology.

Abstract
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Total Hip Arthroplasty Treats Developmental Hip Dysplasia

FRIDAY, April 1 (HealthDay News) -- Cementless modular total hip arthroplasty together with subtrochanteric osteotomy appears to be a satisfactory treatment for patients with prior Crowe Group-IV dysplasia of the hip, according to research published in the March 16 issue of The Journal of Bone & Joint Surgery.

Abstract
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Risks for Complications After Scoliosis Surgery Identified

FRIDAY, April 1 (HealthDay News) -- Children who undergo surgery for neuromuscular scoliosis are more likely to have major complications if they are nonambulatory and if their curve magnitude is 60 degrees or more before surgery, according to a study published in the April 1 issue of Spine.

Abstract
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Cancer Rates, Cancer Mortality Rates Falling in U.S.

FRIDAY, April 1 (HealthDay News) -- Newly diagnosed cancer rates and cancer-related mortality rates in the United States are steadily declining, according to the "Annual Report to the Nation on the Status of Cancer," published online March 31 in the Journal of the National Cancer Institute.

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Similar Graft Survival for Recipients of Older Kidneys

FRIDAY, April 1 (HealthDay News) -- Total graft survival during a four-year follow-up period is comparable for recipients of kidneys from older (age 60 years or older) donors, younger donors, or from deceased standard criteria donors (SCDs), according to a study published online March 14 in the American Journal of Transplantation.

Abstract
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Autoimmune Diseases Number Two Cause of Chronic Illness

FRIDAY, April 1 (HealthDay News) -- Autoimmune diseases are the second leading cause of chronic illness in the United States and constitute a major direct and indirect economic burden to the U.S. health care system, according to a report released by the American Autoimmune Related Diseases Association (AARDA) on March 22 at a congressional briefing.

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